灵枢经·五癃津液别 Urinary Blockage and the Five-Fold Differentiation of Fluid and Humor
黄帝问于歧伯曰：水谷入于口，输于肠胃，其液别为五，天寒衣薄，则为溺与气，天热衣厚则为汗，悲哀气并则为泣，中热胃缓则为唾。邪气内逆，则气为之闭塞而不行，不行则为水胀，余知其然也，不知其何由生？愿闻其道。
歧伯曰：水谷皆入于口，其味有五，各注其海。津液各走其道，故三焦出气，以温肌肉，充皮肤，为其津，其流而不行者为液。
天暑衣厚则腠理开，故汗出，寒留于分肉之间，聚沫则为痛。
天寒则腠理闭，气湿不行，水下留于膀胱，则为溺与气。
五藏六府，心为之主，耳为之听，目为之候，肺为之相，肝为之将，脾为之卫，肾为之主外。故五藏六府之津液，尽上渗于目，心悲气并，则心系急。心系急则肺举，肺举则液上溢。夫心系与肺，不能常举，乍上乍下，故咳而泣出矣。
中热则胃中消谷，消谷则虫上下作。肠胃充郭，故胃缓，胃缓则气逆，故唾出。
五谷之津液，和合而为膏者，内渗入于骨空，补益脑髓，而下流于阴股。
阴阳不和，则使液溢而下流于阴，髓液皆减而下，下过度则虚，虚，故腰背痛而胫酸。
阴阳气道不通，四海闭塞，三焦不写，津液不化，水谷并行肠胃之中，别于回肠，留于下焦，不得渗膀胱，则下焦胀，水溢则为水胀，此津液五别之逆顺也。
Huangdi asked Qibo: 'When water and grain enter the mouth and are transported to the intestines and stomach, their fluid separates into five kinds. When the weather is cold and one's clothing is thin, it becomes urine and qi; when the weather is hot and one's clothing is heavy, it becomes sweat; when grief and sorrow cause the qi to converge, it becomes tears; when there is heat in the middle and the stomach becomes slack, it becomes saliva. When evil qi rebels internally, the qi becomes blocked and fails to move, and when it fails to move, this becomes water-swelling. I understand that this is so, but I do not know from what it arises — I wish to hear the explanation.'
Qibo said: 'Water and grain both enter through the mouth; their flavors are five in number, and each flows into its own sea. Fluid and humor each travel along their own pathway. Thus the triple burner releases qi, warming the muscles and flesh and filling out the skin — this is jin, the fluid; that which flows but does not circulate freely is ye, the humor.'
When the weather is hot and one's clothing is heavy, the interstices open and so sweat is released; if cold lingers between the interstitial flesh, it gathers into froth and this produces pain.
When the weather is cold, the interstices close, and the qi and dampness fail to circulate; the water then descends and lodges in the bladder, becoming urine and qi.
Among the five viscera and six bowels, the heart serves as their ruler, the ears as their hearing, the eyes as their watch, the lung as their minister, the liver as their general, the spleen as their guard, and the kidney as the governor of the exterior. Thus the fluid and humor of the five viscera and six bowels all seep upward into the eyes. When the heart is stricken with grief and the qi converges, the heart's connecting vessel becomes tense; when the heart's connecting vessel becomes tense, the lung is drawn upward; when the lung is drawn upward, the humor overflows upward. Now the heart's connecting vessel and the lung cannot remain constantly drawn upward — they rise and fall by turns — and so one coughs and tears flow forth.
When there is heat in the middle, the stomach digests food rapidly; when food is digested rapidly, parasites are stirred and move up and down. The intestines and stomach become distended and full, and so the stomach becomes slack; when the stomach becomes slack, the qi rebels upward, and so saliva is expelled.
The fluid and humor of the five grains, blended and harmonized into a rich, oily essence, seeps internally into the hollows of the bones, supplementing and benefiting the brain and marrow, and flows downward into the inner thighs.
When yin and yang lose their harmony, this causes the humor to overflow and pour downward into the genital region; the marrow and humor both diminish and descend, and when this descent is excessive, deficiency results — hence there is pain in the lower back and back, and aching in the lower legs.
When the pathways of yin and yang qi fail to communicate, the four seas become blocked and closed, the triple burner fails to drain properly, and fluid and humor fail to be transformed; water and grain then travel together through the intestines and stomach, separate out at the large intestine, and lodge in the lower burner. If they cannot seep into the bladder, the lower burner becomes distended, and when the water overflows, this becomes water-swelling. This is the accord and opposition in the five-fold differentiation of fluid and humor.